What Are the Signs and Symptoms of Hypotension?

Orthostatic Hypotension

The symptoms of orthostatic hypotension happen within a few seconds or minutes of a person standing up after sitting or lying down. They go away if the person sits or lies down again. The signs and symptoms include:

• Dizziness or feeling lightheaded
• Blurry vision
• Confusion
• Feeling faint or weak
• Fainting

Neurally Mediated Hypotension

The symptoms of neurally mediated hypotension (NMH) happen after a person has been standing for a long time or in response to an unpleasant, upsetting, or frightening situation. Like orthostatic hypotension, the drop in blood pressure with NMH is temporary and usually goes away after the person sits down. The signs and symptoms of NMH are similar to those of orthostatic hypotension.

Severe Hypotension Associated With Shock

In shock, not enough blood flows to the major organs, including the brain.

The early signs and symptoms of reduced blood flow to the brain include lightheadedness, sleepiness, and confusion. In the earliest stages of shock, it may be hard to detect any signs and symptoms. In older people, the first symptom may only be confusion.

As shock worsens, eventually, the person cannot sit up without passing out. If it continues, the person will lose consciousness. Shock is often fatal if not treated.

Some of the other signs and symptoms of shock vary, depending on the cause. When shock is caused by low blood volume (such as from massive bleeding) or poor pumping action by the heart (as in heart failure):

• The skin becomes cold and sweaty. It often looks blue or pale. If pressed, the color returns more slowly than normal. A bluish network of lines can be seen under the skin.
• The pulse becomes weak and rapid.
• The person begins to breathe very quickly.

When shock is caused by extreme widening or stretching of blood vessels (such as in septic shock), a person feels warm and flushed at first. Later, the skin becomes cold and clammy, and the person feels very sleepy.